Robotic Assisted Surgery for Obstetrics/Gynecology

Dr. Carin Craig & Dr. David Raphael

Work with the Da Vinci Robot for Minimally Invasive OB/GYN

Carin Craig, MD and David Raphael, MD are both board certified by the American Board of Obstetrics andGynecology. They practice at Sansum Clinic Obstetricsand Gynecology at 515 West Pueblo Street in SantaBarbara. For more information or to schedule anappointment, please call (805) 681-8911.

The da Vinci robot is now serving as a phenomenal tool for gynecologists to use in what are considered to be the more challenging surgical procedures. "Now we have a laparoscopic procedure using a robot which enables us to manipulate the tissues with more dexterity and precision than just doing a standard laparoscopy," said Dr. David Raphael, obstetrician/gynecologist. Not only is the robot safe and effective, it is also minimally-invasive.

It is a common misconception that the robot actually does all the work. "There is a console where the surgeon sits and looks through a three-dimensional visualization which allows improved depth perception," said Raphael. Only a few components are at the scene. "The robotic cart has three or four arms that hold the instruments that are attached to the patient, there is a camera and vision system that allows the three-dimensional imaging and there are instruments that attach to the robot and are controlled by the surgeon's hands," said Raphael. While the surgeon sits comfortably looking at the patient's pelvis, he can send signals to the robot that controls the instruments. "The robot interprets your movements and moves the instruments as if you are moving them yourself," said Raphael. The robot can easily access areas that would normally be hard for the surgeon to reach.

The robot is used in cases ranging from gynecologic cancers to fibroids that can be removed without making an incision. It can also be used to treat conditions including heavy uterine bleeding, excessive menstrual bleeding, uterine prolapse, vaginal prolapse and bladder cancer. All parties involved are pleased with the results. "From a surgical standpoint, you have better visualization, improved depth perception and better dexterity and manipulation," said Dr. Raphael. This equates to a better operation. "In addition to facilitating easier movement, the da Vinci system offers HD vision that allows you to see blood vessels and tissues up close, allowing more accuracy with the surgery," said Dr. Carin Craig, obstetrician/gynecologist.

The robot is also helpful when it comes to suturing. "It enables us to sew things up inside the belly by using the robotic cams and it does suturing which in straight laparoscopy is more difficult," said Raphael. For patients, the benefits are clear as well. "Using the da Vinci robotics system allows a gynecologist to minimize abdominal incisions resulting in shorter recovery, less pain and blood loss, and shorter hospital stays. This offers more surgical confidence to patients," said Craig. As patients are usually anxious about procedures, having this information may help alleviate some stress.

The third-generation da Vinci robot used by Drs. Raphael and Craig is a testament to just how advanced the department of obstetrics/gynecology is at Sansum Clinic. The robot is expensive so it is not available in many communities our size, and many doctors are not motivated to use it because it requires special training and certification. Raphael and Craig each have years of experience under their belts, and continue to learn how to adapt surgical procedures to accommodate new technology. This way they can continue to tackle cases that were traditionally done via larger abdominal incisions.

Gynecologists recommend the da Vinci because it allows patients to maximize their quality of life due to the speedy recovery. "It is extremely rewarding to watch your patients go home the next day and return to their regular activities within one to two weeks versus months," said Craig. With the considerations of having less postoperative pain, less recovery time, blood loss reduction, fewer risks of postoperative complications such as infection and a shorter hospital stay, Raphael and Craig encourage readers to consider discussing the robot as an option for gynecologic surgery with their healthcare provider.